“The Clap Doctor”, “The Father of Spin,” and Other Historical Lessons
for Syphilis Elimination
Bill PetzNorth Carolina HIV/STD Prevention
and Care Branch
Treponema
“What Will My Future Be Like?”
“Syphilis Elimination: History in the Making”
• “Current STD prevention & control not sufficient”
• “New strategies required”
• “Combining intensified traditional approaches with innovative approaches can generate new synergy and enhance effectiveness”
Five Strategies
• Enhanced surveillance
• Enhanced health promotion
• Expanded clinical and laboratory services
• Rapid outbreak response*
• Strengthening community involvement and partnerships*
*”new in many parts of US”
Community Involvement and Partnerships
• “acknowledges and responds to the effects of racism, poverty, and other relevant social issues on the persistence of syphilis”
• Other: Sexism, homophobia, substance abuse, stigma, distrust of government, privacy, confidentiality, prostitution
• Still other: political will, moralistic judgment, …….
Not successfully included in past efforts to eliminate syphilis
• Consideration of the social context in which syphilis persists
• Affected communities and the agencies that serve them
Requirements for Success
• Commitment, investment and collaboration of opinion leaders and program managers
• Members and leaders of affected communities involved in design and delivery of services and shared ownership of interventions
History Already Made
Edward Bernays1891-1995
“Father of Public Relations”
• Nephew of Freud• Selling of WW I & II• Women’s smoking• Fluoridation of water• “engineering of
consent”
Edward Bernays
• Medical Reviews of Reviews 1912
• Play “Damaged Goods”
• Support actor Richard Bennett’s goal to produce the play
• “Sociological Fund Committee” prominent membership and funding to educate public on STDs
Damaged Goods
• Opened in NYC on Broadway March 1913
• Rave reviews for open discussion (not for the drama or acting)
• Presented in Washington for government leaders April 1913
• Support from the powerful for value of the message
Dr. Ben Reitman1879-1942
“The Clap Doctor”• Born in poverty• “King of Hobos”• Lover and manager for
Emma Goldman• Birth control advocate• Sociological studies• Numerous affairs
Ben Reitman
• Cook County Remedy Company
• 1917 established Chicago’s first VD clinic
• 1922 Chicago VD campaign
• 1923 County jail & House of Detention Clinics established
• 1924 Prevention information to 500,000 homes; 1937 syphilis testing survey
• 1937 Chicago Syphilis Control Project
Chicago Syphilis Control
• One million tests in 2 years
• Half of elementary school children tested
• 42,000 cases found• 20% of African
American tested were infected
Chicago Syphilis Control
• Reitman creates Chicago Society for Prevention of VD
• 100 talks in 2 years
• Takes leaders to high morbidity areas
• Takes disenfranchised to churches, schools
• Special Investigator for Project
Ben Reitman
• Advocates for full and accurate information
• Promotes barrier prevention rather than “moral prophylaxis”
• Predicts condoms will be available in schools
• Challenges authorities and fired
National Efforts
• 1937 Surgeon General Parran’s program
• Explicit public support from President Roosevelt
• Collaboration with states, cities, community groups, business, churches
• “bad blood war wagon”
• Dr. Vanderlehr’s assessment
New and Innovative
• Social marketing• Media advocacy• Mobile units• Jail and prison
screening
• Public opinion leaders• Faith based initiatives• Community advocacy
New synergy
• ‘acknowledges, and responds to the effects of racism, poverty, and other relevant social issues on the persistence of syphilis” AND WORKS TO ELIMINATE THEM
• Treats quality health care and health disparities as a justice issue
• Broadens the concept of moral issues
Treponema
“What Will My Future Be Like?”